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Report a Public Issue

2. Date

4. First Name*

5. Last Name*

7. Contact Method

   1. Email
   2. Phone

8. Email

9. Phone

11. Address of Problem*

13. Reported

    1. Call in
    2. Office visit
    3. Online

14. Type of Issue*

    1. Code Enforcement/Residential
    2. All other issues

16. Please briefly describe what the problem is and why it needs to be addressed.*

18. Media upload

    Please upload any images, sound clips, or other media files relevant to the reported issue.

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19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit

* indicates a required field